A Brilliant Plan for Preserving Pharmaceutical Progress (Part 1)

DrRich | March 15th, 2011 - 1:16 pm

Podcast:

Evidence is building that our pharmaceutical industry is becoming diminished.

Recently, for instance. Pfizer announced a $2 billion cutback in R&D funding. One does not so massively trim R&D because of mere cyclical economic conditions; one only does this as part of a fundamental restructuring in business strategy.

Furthermore, the Wall Street Journal has noted that the big drug companies have entered a period of rapid acceleration in company mergers – but decidedly not in the manner of “creative destruction” that usually typifies such deals. Rather, it is being done in the manner of constructing a hardened shelter from which to hunker down for the coming nuclear winter, which they believe will be brought on by government-induced disincentives for innovation and growth.

Now, nobody needs to remind DrRich that drug companies are evil. DrRich has watched along with all of you as the pharmaceutical industry has fired off a never-ending parade of wasteful “me too” drugs, mainly aimed at keeping the joints, bowels, bladders and genitalia of aging baby boomers nicely lubed up, then running a steady stream (so to speak) of television commercials regarding same, which renders prime time TV far too embarrassing to watch with adolescents (especially if one is of a certain age).

Other evil behaviors abound. We can all see the drug companies systematically fail to publish research that makes their products look less than spectacular; routinely over-hype research that suggests a modicum of effectiveness; callously corrupt doctors with plastic, logo’d ink pens, and likewise corrupt legislators with huge campaign contributions and rides on private jets equipped with plenty of booze and bimbos (causing the indignant legislators to propose laws against logo’d ink pens); and most annoying of all, gouge American citizens with astronomical prices for their new drugs, while selling those same drugs to Canadians and other undeserving foreigners at greatly discounted prices.

But still, most objective observers must reluctantly admit that, every now and then, and most likely by mistake, a drug company will do something worthwhile. Here and there they manage to come up with a real breakthrough product that cures a disease, prolongs survival, restores functionality, or relieves suffering. That is, the pharmaceutical industry (in spite of all its evil behavior, which DrRich hastens to remind his readers he has formally acknowledged, as recently as in the prior paragraph), has done a lot of good over the years. Ask a parent whose child has survived acute leukemia, or the person who has survived a life-threatening infection, or the woman whose heart attack or stroke was aborted with clot-busting drugs, or – yes, this too -  the aging Lothario who once again can enjoy fine and durable erections upon demand. Such individuals, even if today they would join us in cheering on the demise of the pharmaceutical industry, have undeniably had their lives improved by drug companies.

So the question we must address before allowing the pharmaceutical industry to roll itself into a ball and hide in the shadows for the duration, is not, “What have you done for me lately?” (since their inventions will live on even if they do not), but rather, “What can you do for me tomorrow?”  Some of us in the boomer class, for instance, would like to think that current research in the areas of Alzheimer’s, Parkinson disease, kidney disease, heart attack, stroke, arthritis, osteoporosis and cancer will allow us to remain healthy and functional for a few extra years. And judging from the massive amounts of money American citizens of all ages donate to medical research of all types, it is apparently not held among the whole of the populace that medical progress has already gone far enough. Many of us would not be entirely pleased to stand pat right here. Many of us would like to see more improvements.

And here is where we run into a dilemma.

Everyone agrees that the cost of new prescription drugs has been kept obscenely high in the name of maximizing profits, and that the rising cost of drugs has been one of the prime drivers of healthcare inflation. Accordingly, we hear much talk of federal price controls, drug re-importation, more restrictive FDA policies, and other tools the Central Authority can employ to greatly restrict if not eliminate the huge profits made by the evil men (and, one must say it, women) who run these drug companies.

The problem, of course, is that if the potential for reaping large (obscene, if you insist) profits from new drugs is significantly curtailed, the hugely expensive process necessary for drug companies to bring new drugs to market will be proportionally curtailed. So if we place price controls on drugs, then we’d better be happy with the drugs we have today, because those are likely the only drugs we’ll have tomorrow.

There are some who would be quite satisfied with this outcome, and who would readily sacrifice pharmaceutical progress to keep costs down. Still, others of us appreciate the fact that every few years some truly earth-shattering drug will hit the market, and would think it a shame if progress on such drugs – even if they are but a few scattered islands in a sea of boutique pharmaceuticals – were to come to a halt, and even if for a good reason.

So here’s the question: Can we have our cake and eat it too? Can we bring down the price of the drugs we buy, while at the same time allowing at least some pharmaceutical advances to continue?

DrRich is delighted to reply, “Yes, we can!”

And he hereby humbly offers a plan to achieve this very end. It is a system of voluntary price controls. Of course, DrRich is talking here about us doing the volunteering – we the consumers – and not the drug companies.

DrRich’s Voluntary Price Control System works like this:

1) Each American will make a formal declaration of whether or not he/she wants to participate in a system of voluntary price controls on drugs.

2) Those who opt to participate will receive immediate, substantial discount pricing on all available prescription drugs, such pricing to be fixed by a sympathetic government agency whose makeup will include a wide diversity of representation, except, of course, that drug company representatives and their physician shills will be specifically banned.

3) “Available prescription drugs” under this price control system will be any drug whatsoever appearing in the U. S. Pharmacopoeia – that is, any legal prescription drug – as long as that drug has been on the market for at least five years.

4) Individuals who choose not to participate in the price control system will pay whatever price the drug companies feel like charging them for all their prescription drugs, but they will be allowed to receive any drug, as soon as it is approved for marketing, with no five-year waiting period for new drugs.

5) Individuals may switch their status (between participant and non-participant) only during one 30-day window every 2 years, determined by their month of birth.

Why DrRich’s Voluntary Price Control System is brilliant:

For drug companies it is the prospect of making large profits from new drugs, and only that prospect, that drives drug development. So as long as we want new drugs to be invented we’ve got to allow for the profit incentive to continue, as odious as we may believe that to be. The chief advantage of DrRich’s system is that it maintains at least some of the profit motive – to whatever extent citizens opt to be non-participants in the Voluntary Price Control System.

Given the growing hue and cry for price controls on drugs, one can confidently predict that only rich people will opt for this non-participant status. Therefore, a side benefit of this plan is that the rich – those who, after all, can afford it, and who, by virtue of the very fact that they are rich, owe much to the rest of us – will fund virtually all progress in drug therapy. Again, this is a burden they ought to feel obligated to bear, being rich and therefore obligated.

In contrast, under the universal, mandatory price control system of the kind that many Progressives seem to favor, the drugs available to our citizens would be essentially “frozen in time,” and henceforth there would be little or nothing new under the sun.

Of course, under DrRich’s Voluntary Price Control System, access to new drugs would be similarly restricted for participants. Yet this voluntary system would be far better for even those who choose to participate than would be a universal price control system – because under DrRich’s plan at least some drug progress would continue. And as new prescription drugs matured in the marketplace, and once their hidden dangers and side effects – during the 5-year “shakedown period” -  manifested themselves on the physiology of the wealthy (another great benefit of DrRich’s plan), these drugs would, eventually become available even to plan participants, and at a substantial discount to boot. And because only the rich will be harmed for the first few years, perhaps the FDA can relax its safety standards a bit, and pass a higher percentage of the effective drugs that are submitted for approval.

The bottom line: a five-year lag in gaining access to new drugs is vastly better than never having any new drugs at all, especially when the burden of paying for all that drug development, and the risk of becoming early adopters of new, relatively unproven, relatively risky pharmaceuticals, falls entirely on the undeserving rich.

So, while at first blush you may not like DrRich’s system – it being two-tiered and all – on further objective and logical reflection DrRich is confident you will see that it is far better for everyone than the universal system of price controls which many now want.

DrRich suggests you contact your legislators immediately to recommend to them this brilliant new plan, before it is too late. In making your case, you might remind your dedicated congresspersons that a robust pharmaceutical industry is inherently good for America, what with all the campaign contributions, airplane rides, booze, bimbos, etc. it provides to grease the wheels of American democracy.

2 Responses to “A Brilliant Plan for Preserving Pharmaceutical Progress (Part 1)”

  1. SteveSC says:

    Why have the FDA involved in the first five years at all? After all, the rich have the resources to make sure the new drug is safe and effective (enough), and are either smart enough, or can hire someone, to make the cost v. benefit calculations.

    Drug companies will like this since they will only have to do as much research as it takes to persuade the patients and their doctors (and probably financial advisors). Patients will like it because they will be the ones to decide whether a 10% chance of acne is worth an extra 3 months survival with cancer. And the FDA should like it, because they will have 5 years of real world experience with a drug before they have to approve it, which should reduce the risk exposure of every involved bureaucrat.

  2. Doc99 says:

    How about simply making all drugs advertised Direct to Consumer over the counter. Let CVS and Pharm deal w the liability.

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